Genital Pain and Intimacy

Q: "I have vulvodynia and other chronic pain conditions and I don't spend a lot of time with my bits because pain, and effort, and it's just... not very fun, or appealing? But I'm dating someone who's very sexual, and I like doing things with them and the way my body feels when things get steamy, and it's clear that they're up for doing more but are letting me set the pace.





I don't really know how to... introduce them to my genitals? I can tell them the things that will definitely feel *bad*, but I can't really tell them what feels *good* because I genuinely don't know, and I get really self-conscious in the moment. The last few partners I've had have either been super anxious about inadvertently hurting me (which then made me super anxious), or I've felt like I needed to push through the pain because it was probably inevitable and I didn't want it to stop us from having a good time. My pain levels have also gotten worse since the last time I negotiated intimacy like this, so I'm extra nervous about trying again two years later.





I'd appreciate any advice you can offer!"





A: Thanks for your question. I have some ideas for your situation. In terms of how to talk about your genitals, I would suggest having this discussion in a relaxed non-sexual setting. That way, you both can have a good discussion and your partner can ask questions and you can brainstorm together and talk about your wants, desires, do’s, and don't’s. Having a safeword or gesture helps during sex. Safewords can be anything and when either of you needs to pause or stop. You can just say it instead of worrying about explaining what you are feeling at the moment. Reassure your partner that they are not hurting you rather this is just how your body works. You have every right to say stop when you need to, you shouldn’t force yourself through the pain for your partner's sake, because I guarantee your partner wouldn’t want you to either, sex is all about the journey of mutual pleasure. Also if this is appealing for you, experiment with masturbation. See what feels good/neutral and what doesn't, and take it slow, don’t try to force anything. Then when you are with a person you can tell them what you’ve experienced as pleasurable. Also, note there are SO many different ways to have sex that aren’t centered on genitalia or penetration. The body has so many ergonous zones for you to experience pleasure and even orgasms for some people!

Trauma and Sex

Q: “ (cw childhood sexual assault mention)


Hi, I have CFS/ME and fibromyalgia, but I also have chronic vaginal neuropathic pain following a not so successful genital upcycling surgery five years ago (I'm trans). I also have a csa history and consequent C-PTSD. I definitely have a sexuality but I'm afraid to express it in company, because I don't know how to work with fear of physical pain from being touched. Do you have any suggestions/recommendations for how to work with stuff like this? It's ruined a number of relationships over the years, and made me functionally asexual with others.”
A: Thanks for your question. I would suggest playing with sex that does not involve your genitals. That could mean making out, exploring the many other erogenous zones of your body, massage (which is also great for your fibromyalgia), using toys on your partner or your self (in areas that feel pleasurable -which could be anything from your nipples, neck, back of your knees, feet, etc! Everyones different).






In terms of your fatigue, telling your partner exactly how to get themselves off is a great way to be intimately involved without physically exerting yourself. You still have the control and can lie next to your partner while they are having fun. Also talking to your partners about how you need to take it slow is a good idea. You don’t have to go into why you need time to become comfortable, or why you might need to stop sometimes, but just explain that this is a part of being with you. There are many different ways one can have sex and feel intimate with their partner, so just keep an open mind, have patience, and communicate!